<!DOCTYPE html>
<html lang="en">
  <head>
    <meta charset="utf-8">
    <meta name="viewport" content="width=device-width, initial-scale=1.0">
    <meta name="description" content="">
    <meta name="author" content="">
    <link rel="shortcut icon" href="assets/ico/favicon.png">

    <title>Signin Template for Bootstrap</title>

    <!-- Bootstrap core CSS -->
    <link href="dist/css/bootstrap.css" rel="stylesheet">

    <!-- Custom styles for this template -->
    <link href="signin.css" rel="stylesheet">

    <!-- HTML5 shim and Respond.js IE8 support of HTML5 elements and media queries -->
    <!--[if lt IE 9]>
      <script src="assets/js/html5shiv.js"></script>
      <script src="assets/js/respond.min.js"></script>
    <![endif]-->
  </head>

  <body>

    <div class="container">
<!------ Form Start --------->
      <form method="post" action="saveuser.php" class="form-horizontal" role="form">
        <h2 class="form-signin-heading">Please fill the details below</h2>

        <div class="form-group">
          <label for="inputName" class="col-lg-2 control-label">Name</label>
          <div class="col-lg-10">
            <input autocomplete="off" name="name" type="text" class="form-control" placeholder="My Name is">
          </div>
        </div>


        <div class="form-group">
          <label for="inputEmail1" class="col-lg-2 control-label">Email</label>
          <div class="col-lg-10">
            <input autocomplete="off" name="email" type="email" class="form-control" id="inputEmail1" placeholder="Email">
          </div>
        </div>

        <div class="form-group">
          <label for="inputPassword" class="col-lg-2 control-label">Password</label>
          <div class="col-lg-10">
            <input autocomplete="off" name="password" type="password" class="form-control"  placeholder="Password">
          </div>
        </div>

        <div class="form-group">
          <label class="col-lg-2 control-label">Confirm Password</label>
          <div class="col-lg-10">
            <input autocomplete="off" name="c_password" type="password" class="form-control"  placeholder="Confirm Password">
          </div>
        </div>


        <div class="form-group">
          <label class="col-lg-2 control-label">Security Code</label>
          <div class="col-lg-10">
<!-- Captcha Start -->
<img src="captcha/captcha.php" id="captcha" /><br/>
<a href="javascript:void(0)" onclick="    document.getElementById('captcha').src='captcha/captcha.php?'+Math.random();
    document.getElementById('captcha-form').focus();"
    id="change-image">Not readable? Change text.</a><br/><br/>
<input type="text" placeholder="Security Code" required name="secretword" id="captcha-form" /><br/>
<!-- Captcha End-->

          </div>
        </div>


        <div class="form-group">
          <div class="col-lg-offset-2 col-lg-10">
            <input type="submit" class="btn btn-primary btn-lg" value="Sign in">
          </div>
        </div>
      </form>
<!------ Form End --------->
    </div> <!-- /container -->


    <!-- Bootstrap core JavaScript
    ================================================== -->
    <!-- Placed at the end of the document so the pages load faster -->
  </body>
</html>
